Clinical Interventions in Aging (Apr 2022)
Clinical Value of Inflammatory Cytokines in Patients with Aneurysmal Subarachnoid Hemorrhage
Abstract
Cong Luo,1 Jiaxin Yao,1 Haoran Bi,2 Zhen Li,1 Ju Li,3 Guosong Xue,3 Ke Li,3 Shenyang Zhang,3 Kun Zan,3 Wenqing Meng,3 Zunsheng Zhang,3 Hao Chen3 1Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Biostatistics, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 3Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of ChinaCorrespondence: Zunsheng Zhang; Hao Chen, Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, People’s Republic of China, Tel +86-13913473179 ; +86-15252006510, Email [email protected]; [email protected]: Inflammation is closely associated with prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH), which is orchestrated by inflammatory cytokines. Therefore, this study aimed to investigate the levels of inflammatory cytokines in the early stage of aSAH and their predictive value for prognosis.Methods: In this retrospective study, 206 patients with aSAH were recruited and assigned to a severe group (WFNS grade ≥ 4) and a mild group (WFNS grade < 4) according to the severity of patients on admission. Flow cytometry was performed to detect the levels of 12 inflammatory cytokines in the serum of patients. Then, patients were grouped into a poor prognosis group (mRS score ≥ 4) and a good prognosis group (mRS score < 4) based on their prognosis after 3 months of discharge to compare the relationship between cytokines and prognosis. Propensity score matching (PSM) was utilized to control confounding factors. The correlation between inflammatory factors and prognosis was determined using Spearman correlation, and the predictive efficacy of inflammatory factors was tested by a receiver operating characteristic curve.Results: Serum IL-1β, IL-5, IL-6, IL-8, IL-10, IFN-γ, and TNF-α levels were significantly higher in the mild group than in the severe group and in the poor prognosis group than in the good prognosis group. After PSM, the differences in IL-1β, IL-5, IFN-α, and IFN-γ levels disappeared between the two groups, whereas IL-2, IL-6, IL-8, IL-10, and TNF-α levels remained higher in the poor prognosis group than in the good prognosis group. Additionally, IL-2, IL-6, IL-8, and IL-10 levels were positively correlated with mRS scores. Moreover, the predictive value was found to be the highest for IL-6 and the lowest for TNF-α.Conclusion: Inflammation degree was related to the severity of aSAH. Inflammatory markers, including IL-6, IL-10, IL-8, IL-2, and TNF-α, might predict the poor prognosis of aSAH.Keywords: aneurysmal subarachnoid hemorrhage, inflammation, cytokine, prognosis, propensity score matching
